← Issue №8/ week of Aug 23, 2026/Hepatology

ROTEM-guided blood product transfusion in patients with cirrhosis having invasive procedures: a randomized controlled trial.

From GI Signals issue №8: what this paper found, what it changes, and where it sits against the current standard of care, reviewed by Simon Mathews, MD.

Hepatology rct · n=57 · Aug 20, 2026 · Clin Gastro Hep · IF 16.2

ROTEM-guided blood product transfusion in patients with cirrhosis having invasive procedures: a randomized controlled trial.

Practice-changingcirrhosis
Clinical takeawayIn cirrhotic patients with abnormal INR or platelet counts undergoing invasive procedures, implement ROTEM-guided transfusion protocols instead of routine prophylactic transfusion to reduce unnecessary blood product exposure while maintaining hemostatic safety; adoption requires ROTEM availability and institutional protocol support.
What it foundROTEM-guided transfusion reduced prophylactic blood product administration from 97% (28/29 procedures) in standard care to 71% (20/28 procedures) without increasing major bleeding, thrombosis, or mortality.
ContextChallenges the routine practice of prophylactic transfusion in cirrhotic patients with abnormal INR or platelet counts; demonstrates that a more conservative, goal-directed approach using ROTEM is safe and significantly reduces transfusion burden.
No standard claimed for this paper

Every paper is compared to the standard governing its question. This one is not: either no standard in the corpus matches it, or the comparison did not hold up on review and was withdrawn rather than published unverified. Both are logged.

Janko N … Roberts SK · Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association · IF 16.2 · PubMed ↗Permalink
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